He was 65 years old. Decades of smoking left him with laryngeal cancer. A laryngectomy ensued, destroying his ability to speak. The plastic amplifier managed to translate guttural rumblings into intelligible sounds. But the cancer had recurred and, in its relentless march, had surrounded and invaded the esophagus, making swallowing impossible. We inserted a feeding tube into the stomach via the abdomen, and attempted to provide adequate nutrition.
As days went by, the physical deterioration was obvious; analgesic requirements increased, but the pain seemed invincible. Each morning I would walk to the surgical wards with the nihilistic hope that I would find an empty bed with a message from the night staff that the patient had "peacefully passed away." As day after day passed, I an impressionable, idealistic, and exuberant young intern was beginning to painfully learn the limitations of modern medicine.
After rounds one day, I returned to the bed side and drew the curtains. The desperate look of pleading in my patient's eyes was punctuated by pathetic grunts. With trepidation, I asked: "Is there something unresolved that's worrying you?"
The steel-blue eyes brimmed with tears as he communicated his unreadiness to die and his unresolved battle with guilt and fear. I shared the simple steps of confession, forgiveness, acceptance of Jesus Christ as his personal Savior, and salvation which is full and free. We wept, and together prayed.
His physical pain dissipated; he fell asleep for the first time in days. Six hours later, he was dead.
What he really needed
What did this patient really need? Painkillers? Yes. Hygiene and bathing? Yes. Nutrition? Yes. But most importantly, he needed inner spiritual peace and assurance.
A recent article in the Journal of the American College of Surgeons enunciated the need of caregivers to empathize with the dying patient. 1 Apart from the needed therapy related to diagnosis, there should also be careful attention to listening, understanding, and helping.
Are physicians equipped to handle these aspects of wholistic patient care? It has been insightfully suggested that "empathy can and should be the end and the beginning for all who care for the dying." 1 In the struggle with the clock, increasing patient loads and increasingly regulated medical practice environments, is there help in these things for the physician? Is there a pattern, an example?
Of course. "Christ's method alone will give true success in reaching the people. The Savior mingled with men as one who desired their good. He showed His sympathy for them, ministered to their needs, won their confidence. Then He bade them, 'Follow Me.'"2
Physicians and clergy working together
Certainly, physicians by themselves can apply spiritual principles in healing and treat ing, but a blended ministry approach can fur ther empower such a ministry through the physician's close cooperation with clergy.
The biblical commission reflects a blended ministry: "And he ordained twelve, that they should be with him, and that he might send them forth to preach, and to have power to heal sickness, and to cast out devils" (Mark 3:14,15). Similarly, combined ministry is referred to in Luke 9:2: "And he sent them to preach the kingdom of God, and to heal the sick."
We so readily become absorbed by the depth of the world's need! It is a given that, in the helping professions, it is difficult to limit the number of parishioners helped, or for that matter, the number of patients seen.
We need to guard against the trap of living up to the adulations describing how hard we work, or that people simply cannot cope without our help or service. It is important to be appreciated, but equally important not to rise to the bait of ego-boosting, which pushes us further into the vortex of overcommitment, burnout, and thus poor service.
The blended ministry approach may offer some solution to the paradox of the need for total commitment in service, and the much-neglected ingredient of balance.
Establishing doctor-minister partnerships
Establishing working partnerships is important, and a proven partner ship is that of the physician-pastor team. This cooperation represents a formidable influence, both inside and outside of the church.
There are the time-honored ways in which this team has functioned in the past, which include lifestyle interventions and initiatives.
Specific avenues that can benefit from the input of a dedicated physician include weight and stress management programs. Smoking cessation programs enjoy increased credibility when health professionals participate.
Christian physicians are able, and often equipped, to participate in education and prevention thrusts relating to alcohol, tobacco, and drug use. Physicians can support Women's Ministries by presenting on women's health issues; nutrition and risk factor modification programs can be meaningfully enhanced by the input of physicians. These are all initiatives that can be of benefit both to the local congregation and to the community (both in-reach and out-reach).
While traveling on the west coast of the United States, I had the wonderful experience of meeting firsthand with various physician-pastor teams. All these groups shared one very obvious characteristic: an effervescent esprit de corps and an unashamed zeal to serve Christ.
Some conversions to Christ resulting from these partnerships had been triggered by the patient asking to be referred to a minister, not to any minister, but the specific minister who worked with their physician. Often this interest and request had been initiated by a prayer offered by the physician at the sickbed before surgery, or a kind word instead of abruptness when called in the middle of the night.
An important team ingredient
An important ingredient for the successful functioning of the pastor-physician team is an open communication between team members.
The agenda needs to be clear, the objectives defined. Under these circumstances, physicians and pastors will regard each other not as threats but as allies. As talents and abilities are blended and multiplied, the results can be astounding.
In the two churches we have had the privilege of serving, we have teamed up into a blended ministry pastoral team with results and blessings which can be attributed only to God. We witnessed spiritual growth in the Sabbath School, prayer meeting, and church attendance.
In the one church, a blended ministry program had been in place for more than twenty years. We saw a substantial growth in church membership as well as acceptance of our church in the community. A second church was established in the area over this time period. Prejudice had earlier been rampant there. It had festered to the point that, for 15 years, permission to obtain a second church site had consistently been refused.
The blended ministry program and a Christian medical practice helped break down prejudice. Not only was there growth in the church and the stature of the pastoral-physician team, but a steady and consistent Christian influence was felt in the entire community. This resulted in invitations to fill the pulpits of other denominations on occasion, and to counsel and pray positively with local leaders and community decision-makers.
There is another important aspect to the physician-pastor team approach: The physician is drawn into an integral role in soul winning as well as discipleship. At the same time, the subtle (and sometimes not-so-subtle) distractions of busy clinical life can be kept at bay.
An important key to sustained and productive church attendance is knowing that you belong and are use ful. This in turn encourages a renewed striving to find ongoing personal spiritual growth, something both physicians and pastors need!
The expressed need for spiritual direction when dying
In his article titled "The Spiritual Needs of the Dying Patient," Daniel Hinshaw has described the renewed need people are sensing and expressing when it comes to reclaiming and reasserting the spiritual dimension in the face of death. He then elegantly discusses the various aspects of the spiritual needs of the dying patient and their family. There is a need to recognize the spiritual suffering and then to alleviate it.
In doing this, Hinshaw asserts that one of the tools is the taking of a spiritual history, which includes the question: Do you have a faith? He goes on to say that central to this approach is having and showing respect for the patient's values, autonomy, and vulnerability, and making referrals to chaplains or spiritual directors when appropriate and with the consent of the patient. Perhaps the most important principle for the caregiver is to know himself or herself: "You can't address a patient's spirituality until you address your own."3
The care of the dying patient can be enhanced by an appropriate and sensitive cooperation between physician and clergy. Prognosis can temper expectation, and the cooperation between pastoral and physician caregivers can facilitate the complex process of terminal care.
The minister is uniquely equipped to care for the spiritual concerns of both patient and family, resulting in a
win-win scenario.
I have no doubt that blended ministry is effective. After all, it has its origins in divine inspiration and example. Are we going to apply it more broadly and enthusiastically?
"Medical missionary work is a sacred thing of God's own devising. ... Those who cooperate with God in His effort to save, working on the lines in which Christ worked, will be wholly successful."4
As a minister, why not share this article with your selected physician, or if you're a physician, with your selected pastor; and see where it takes you both?
1 Daniel B. Hinshaw, "The Spiritual Needs of the Dying Patient," Journal of the American College of Surgeons, 195, no. 4 (October 2002): 565-568.
2 Ellen G. White, The Ministry of Healing (Nampa, Idaho: Pacific Press Pub. Assn., 1905), 143.
3 Hinshaw.
4 , Medical Ministry (Nampa, Idaho: Pacific Press Pub. Assn., 1932), 131.
